Variola Major's Trail

To fulfill their religious obligations, a group of well-to-do Yugoslav Moslems made a pilgrimage to Mecca and Medina and then visited Baghdad before returning to the Serbian province of Kosovo. Most brought gifts from Iraq. Yugoslav health officials suspect that some also brought back variola major, the most virulent form of smallpox. Two weeks after their homecoming --variola's incubation period--several of the travelers came down with smallpox, triggering an epidemic that has infected 155 and killed at least 28 in just a month. Only now is the outbreak being brought under control.

One of the first victims developed a severe form of smallpox characterized by widespread bleeding spots on the body. Puzzled doctors sent him to two provincial hospitals and finally to Belgrade. As the dying man was moved from place to place, he infected patients and staff in hospitals along the way. He himself became the country's first smallpox fatality. A 19-year-old nurse who had attended him was one of the next victims.

Health authorities quickly moved against the spreading epidemic. Seven American specialists carrying 3,000,000 doses of vaccine and armed with jet injection guns capable of inoculating 1,000 people an hour were rushed to assist Yugoslav health workers in a nationwide immunization campaign. European countries donated vaccine through the World Health Organization. Hundreds of thousands of Yugoslavs responded to government appeals and stood in long lines to be vaccinated.

Postponed Politics. To fight the threat of contamination, hospital visiting privileges were suspended in some parts of the country and a joint session of the federal and Serbian Parliaments was postponed. Foreign tourism fell off sharply. Kosovo was placed under a strict quarantine, and travel from the province was forbidden to all who had not been successfully immunized. When Vuko Dragasevic, Secretary of Labor and Social Welfare, tried to enter Macedonia from Kosovo, he was stopped at the border even though he had a vaccination certificate. He is an official in charge of the nationwide immunization program.

Meanwhile, German officials called a smallpox alert after a Yugoslav worker from Kosovo, newly arrived in Hannover, came down with the disease. He was immediately put in isolation, and officials rounded up 665 people known to have had some contact with him. They were being held in quarantine while the search went on for the 666th and last person believed to have been exposed.

The epidemic was shocking even beyond the dead count because smallpox has been considered all but extinct in industrialized nations (TIME, Jan. 24). Yugoslavia, for instance, had not suffered an outbreak for 40 years. The U.S. Public Health Service no longer requires travelers to have proof of recent immunization before entering the country unless they have been in one of the few places where the disease is still common. Now those arriving from Yugoslavia must show evidence that a vaccination has taken. A person lacking a certificate must keep in touch with health authorities for at least two weeks.

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